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AUG 13 2010 37,ENVIRONMENTRONMENT HEALTI <br />UST SYSTEM RETROFIT OR REPAIR <br />PERMITISERMES Sulmil minimum of 3 sets of plans & applications as originals will be retained by EHD) <br />1. Site map enclosed? YES` <br />Nor) <br />2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training certificates for each <br />person installing or testing any component that is repaired or replaced. Ensure a copy of the "Site Health and Safety <br />Plan" is available on the jobsite as required by Title 8. <br />3. Detailed description o work to be completed. List components to be repaired or replaced and attach a diagram drawn <br />to scale showing loca ion of repairs and/or replacements. If repairing a component, describe how this will be done. (If <br />adding piping, UDC's,j or other UST equipment, or performin tank to u <br />pages 4-8 as necessa for a timely plan review): g p pgrade, use the UST Installation Application <br />t <br />IIL^ <br />0 <br />4. List of equipment to be sed (Attach manufacturer's specification sheets showing third -party approval). - <br />r—\ 9� ,i zi <br />2 <br />2 <br />